No breath(work) without bread: Toward an integrated paradigm for community-owned mindfulness interventions to address structural drivers of human development and health disparities.

Abstract

Mindfulness-based interventions (MBIs) are increasingly used in clinical and community settings and show significant potential to address a broad range of physical and mental health outcomes. This potential has led to calls for ever greater implementation of MBIs internationally, particularly with vulnerable populations and in low-resource settings. However, the effectiveness of MBIs has not been unequivocally demonstrated across populations, contexts, and health outcomes, with some studies failing to show treatment effects or even showing iatrogenic effects. Simultaneously, health care and public health systems globally struggle to address population health needs within a medical paradigm that, in general, individualizes pathology while obscuring the structural causes of health disparities. It is therefore critical to note that most research and practice in the mindfulness space have focused on change processes exclusively at the individual level. In populations lacking access to basic needs such as physical safety, food, shelter, social support, health care, education, and financial stability, change processes at the individual level do not adequately address the conditions that impact human development and produce disease. In this article, we make a call to action urging MBI implementers in global health to (a) center community ownership; (b) attend to inequities in power both within communities and between researchers and communities; (c) engage cross-sector networks of community stakeholders to identify resources, resiliencies, and areas of most urgent need; (d) address community-defined needs and change processes at multiple social-ecological levels; and (e) incorporate complementary interventions that address both basic needs and the social drivers of human development and disease. Drawing on developments in implementation science, social science, and community practice, we provide guidance on directions and methods for future work to achieve these ends. Using this guidance, researchers and interventionists may catalyze the development of a community-owned, materially engaged, relational model of MBI, which has the potential to effect positive social change. (PsycInfo Database Record (c) 2025 APA, all rights reserved).